Organization
LAKE WELLNESS COLLECTIVE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARVIDA FRANCES LAKE LCPC (LEAD THERAPIST)
(919) 741-3481
Entity
Organization
Contact information
Practice address
8609 PARK AVE, BOWIE, MD 20720-3698
(301) 615-0883
Mailing address
8609 PARK AVE, BOWIE, MD 20720-3698
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
05/17/2025
Last updated
05/17/2025
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